Cape Town's response to the Covid-19 pandemic reflects good governance in the city, argues Zahid Badroodien.

The devastating toll of Covid-19 on lives and livelihoods, is aggravated daily by growing stories of government failures, disease control mismanagement, bungling of social relief efforts and an all-out feeding frenzy of corruption by connected cadres.

The picture can seem bleak at first, but a closer look at the Cape metro response effort reveals that much good has been done to slow the spread of Covid-19, and bring new cases under control.

Inspired by this progress, we are advising residents to stay vigilant, so that our health facilities continue to be at lesser risk of being overwhelmed. News last week that the Western Cape has now passed its infection peak, without ever running out of hospital beds, and with capacity to take on other province's patients, was truly telling.

Good governance 

It is becoming clear that this pandemic is revealing the true colours of governance around South Africa. And where good governance prevails, lives and livelihoods have a better chance of making it through this pandemic.

The arrival of the highly infectious Covid-19 virus in Cape Town presented an unprecedented situation to both the provincial and city governments for which there was no luxury of a playbook in designing our organisational response.

As evidenced by both international and national reporting, the attack rate of the virus is relatively high over a short period of time which had every potential to overwhelm the health system, resulting in increased fatalities. 

Cape Town recorded its first positive case on 11 March 2020 through a patient who self-presented to a medical facility. After test results came back, the City was quick to respond by implementing international best practices. We immediately closed all public facilities on 17 March 2020, a week prior to the national lockdown on 26 March.

Cape Town was able to rapidly implement its Covid-19 preparedness plan, based on a data-driven response. 

We knew that we needed to make effective use of the hard lockdown, without wasting a moment, and so we did everything in our power, legally and frugally, to prepare primary healthcare facilities to respond to this growing pandemic.

As Mayco Member for Community Services and Health, part of my responsibility has been to oversee the City's expansion of at least 80 community centres and clinics to the value of R70 million.

With this investment, 153 new examination and treatment rooms have been opened, with access to all the necessary resources required to deliver the health service. We did this without delays or corruption, and in full support of the broader provincial health system efforts.

Whilst there may have been misplaced furore in the beginning of the pandemic by certain political parties slating the city for being the epicentre, this is now proven to have been cheap politics. It may have suited a narrative at the time, but in retrospect, while early caseload did grow fast, we kept up with the need and added the medical capacity it demanded in real time without delay, catering for every patient.

State of affairs 

My heart breaks to think of the avoidable state of affairs in other parts of South Africa today. In Port Elizabeth, people are fighting for their lives to access oxygen in dilapidated and dysfunctional hospitals and clinics. 

In Johannesburg, the city is preparing 1.4 million graves to cope with what will likely be their inability to manage their worsening Covid-19 burden that their facilities will not be able to cope with.

Around South Africa, outside of the Western Cape, field hospitals were inexplicably delayed, and many are still not functioning; ambulance shortages left patients stranded and unable to get treatment; scooter ambulances were laughably introduced in the Eastern Cape despite clearly violating Human Rights; in Gauteng the Nasrec field hospital was built without oxygen and then used to quarantine rather than treat; and disgraceful extravagant PPE corruption stories continue to flow out of Gauteng which is now not only the viral epicentre but also the corruption epicentre of Coronavirus.

In contrast, in Cape Town we are now recording an improvement and decrease in the case load, each day fewer and fewer cases are reported, without any of these fundamental failures because we are quite simply committed to good governance and have taken a Covid-19 smart approach. 

Increased capacity

More importantly we have also made available funding to open up additional posts for doctors, nurses, pharmacists, and environmental health practitioners to respond effectively to the growing health needs. Increased capacity has seen the metro testing more than 410 000 residents in our facilities.

We further employed 490 residents on EPWP contracts to educate and encourage behavioural change in hotspot communities. Using EPWP, we avoided the all-too-often seen examples of massively inflated contracts for "Covid Fieldwork" or "Covid door-to-door", costing millions upon millions of rands in other parts of South Africa.

Cape Town's example offers hope of what is possible when a capable state partners with residents to confront a major societal challenge. To protect both lives and livelihoods, it is now time for national regulations to recognise the efforts in our region and allow all businesses who can open safely, to do so.

- Zahid Badroodien is the MMC Community Services and Health for the City of Cape Town.

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